Varicocele and Male Factor Infertility Treatment: A New Meta-analysis and Review of the Role of Varicocele Repair

Baazeem, Abdulaziz; Belzile, Éric; Ciampi, Antonio; Dohle, Gert R.; Jarvi, Keith; Salonia, Andrea; Weidner, W.; Zini, Armand

doi:10.1016/j.eururo.2011.06.018

Cited by 379 publications

(323 citation statements)

References 73 publications

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“…The mean preoperative sperm count was 17.6x10 6 /mL compared to 19.7x10 6 /mL in the postoperative period (p < 0.0001). The mean preoperative percentage of progressive sperm motility was 13.7% compared to 17.6% in the postoperative period (p < 0.0001).…”

Section: Resultsmentioning

confidence: 91%

“…However, this point is debated by the scientific literature because even prospective randomized controlled trials of varicocele treatment in adults have given conflicting results. Studies on this topic are divided into those that conclude there is no influence on infertility by treatment of varicocele (6,7,14,15) and those that find a real benefit on semen parameters and pregnancy rate (8,9).…”

Section: Discussionmentioning

confidence: 99%

“…The exact association between reduced male fertility and varicocele is not known because prospective randomized studies on varicocele treatment in adults have given conflicting results (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of spermatic vein ligation in patients affected by high grade left varicocele

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To study the effect of high grade varicocele treatment in infertile patients. Materials and Methods: Seventy-five patients were selected by the following criteria: infertility persisting for more than 1 year; abnormal semen parameters; no other infertility--related disease; no obvious causes of infertility in the subject's partner; basal eco-color Doppler ultrasound demonstrating continuous reflux in the spermatic vein. All patients considered for the study had at least a six months period from the diagnosis to the surgery due to waiting list, choice of the patient or time needed to complete diagnostic evaluation of the couple. The surgical procedure was performed through an inguinal approach. All enrolled patients were counseled to have unprotected intercourse during the ovulation period in order to maximize the probability of pregnancy within the 6-month preoperative period. The achievement of pregnancy and semen parameters were recorded during the preoperative and postoperative period. Results: Two of the seventy-five patients were excluded because of persistent varicocele after surgery. The preoperative pregnancy rate was 1.3% (1 couple). The postoperative pregnancy rate was 42.5%. The stratification of pregnancies by semester showed a significantly higher rate in the first postoperative period (p = 0.0012). Mean time to conception was 13.5 months. Mean preoperative sperm count was 17.6x10 6 /mL compared to 19.7x10 6 /mL in the postoperative period (p < 0.0001). Mean percentage of progressive sperm motility was 13.7%, compared to 17.6% in the postoperative period (p < 0.0001). Mean percentage of normal sperm morphology was 7.6%, compared to 15.2% postoperatively (p < 0.0001). Conclusion: Surgical treatment of high grade varicocele proved to effectively treat associated infertility by improving seminal parameters and pregnancy rate in our patient cohort.

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Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Efficacy of spermatic vein ligation in patients affected by high grade left varicocele

et al. 2014

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“…74 However, more evidence is required to make conclusive recommendations regarding repair of subclinical varicocele. 75 …”

Section: Subclinical Varicocelementioning

confidence: 99%

The hemodynamic approach to evaluating adolescent varicocele

et al. 2012

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| During adolescence, the risk of developing a varicocele increases. Prevalence is less than 1% in boys aged younger than 10 years, but approaches that of the general adult population (about 15%) during puberty. For adolescent males with varicoceles, surgical risk factors have not yet been clearly delineated and clinical severity correlates poorly with prognosis. Fortunately, the widespread use of Doppler ultrasonography is transforming the diagnostic work-up for this demographic. A continuous reflux detected by color Doppler ultrasound (CDUS) is thought to have a negative prognostic value and evidence suggests that a peak retrograde flow above 38 cm per second is a powerful predictor of lack of spontaneous improvement in adolescent patients with ≥20% asymmetry between testes. CDUS also enables the detection of varicocele resulting from reflux in the deferential vein adjunctive to a refluxing internal spermatic vein; a causality that accounts for approximately 15% of cases. In addition to a diagnostic role, hemodynamic parameters can be used to predict the risk of persistence or worsening asymmetry. Although further studies are necessary to validate single parameters, it seems that the more severe the reflux, the greater the likelihood that the patient will develop testicular asymmetry.

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“…There are studies showing a negative impact on testicular function already in adolescence (Romeo et al, 2001). The mean incident of varicocele is approximately 15% to 20% in healthy men, and interestingly increases to 40% to 70% in men with primary and secondary infertility, so is the most common identifiable cause of infertility in men (Baazeem et al, 2011;Schauer et al, 2012). The etiology of varicocele is controversial, but three theories on the cause of varicocele are accepted.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Curcumin on Sperm Parameters and Nitric Oxide Production in Varicocelized Rats

et al. 2015

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SUMMARY:One of the proposed mechanism by which varicocele induces its damage is excessive release of nitric oxide (NO). Several studies have shown the role of NO in poor sperm quality in infertile patients with varicocele. Scientific studies have demonstrated the beneficial effects of curcumin on the sperm parameters. Curcumin as an atoxic antioxidant can reduce production of NO. The aim of this study was to determine the effect of curcumin on NO levels and investigate if curcumin can improve sperm parameters in varicocelized male rats. Thirty male Wistar rats were randomly divided into 5 groups (V1 and V2 (varicocele), T (treatment), Sh (sham) and C was control). In groups V1, V2, T and Sh, the left renal vein was partially ligated to induce varicocele. In groups V1 and V2, sperm parameters and NO level were evaluated 8 and 16 weeks respectively after varicocele induction. Groups T and Sh received 100 mg/kg curcumin and placebo respectively, daily for 8 weeks after 2 months of induced varicocele. Sperm parameters (count, motility, viability and morphology), epididymis and testis weight and also NO concentration were measured. Sperm parameters (count, motility and viability) in groups V1, V2 and Sh were significantly low in comparison with control and treatment groups. The level of NO was significantly increased in serum of rats in groups V1 and V2, whereas group T rat serum in which curcumin was administered, showed decreased NO levels. The values of the epididymis and testis weight had no significant changes (P≤ 0.05) in all groups. Administration of curcumin as a free radical scavenger, can decrease NO level and improve sperm parameters in varicocelized male rats.

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Varicocele and Male Factor Infertility Treatment: A New Meta-analysis and Review of the Role of Varicocele Repair

Cited by 379 publications

References 73 publications

Efficacy of spermatic vein ligation in patients affected by high grade left varicocele

Efficacy of spermatic vein ligation in patients affected by high grade left varicocele

The hemodynamic approach to evaluating adolescent varicocele

The Effects of Curcumin on Sperm Parameters and Nitric Oxide Production in Varicocelized Rats

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